RIO DE JANEIRO, 25-26 october 2010 IV WORLD PASTA CONGRESS LOW CARB DIETS MAY NOT BE SAFE Prof. Pietro A. Migliaccio President of Italian Society of Nutritional Science (S.I.S.A.).) Internet: www.migliaccionutrizione.it E-mail: : pietromigliaccio@migliaccionutrizione.it
THE MEDITERRANEAN DIET In 2010, due to its well known international value the traditional Mediterranean Diet has been recognized as IMMATERIAL TREASURE OF THE HUMANITY UNESCO (United Nations Educational, Scientific and Cultural Organization)
Metanalysis of all studies performed since 1966 to date on relationship between mediterranean diet, chronic diseases and mortality have demonstrated a strong association between adhesion to this type of diet and improvement of health. In particular, Mediterranean Diet has been found to be linked to 9% reduction of mortality due to cardiovascolar disease, 6% to cancer, 13% decrease of incidence Parkinson and Alzheimer diseases. These results are very important for social health, and strongly suggest that the Mediterranean Diet could be used as tool for primary prevention for chronic diseases. Sofi F, BMJ 2008 Sep, Adherence to Mediterranean diet and health status: metaanalysis.
MAIN POINTS OF THE MEDITERRANEAN DIET LARGE INTAKE OF VEGETABLES (BREAD, PASTA, LEGUMES, VEGETABLES AND FRESH FRUITS) LIMITED INTAKE OF ANIMAL ORIGIN FOOD AND CHEESES (BETTER POULTRY AND FISH) LIMITED INTAKE OF ALCOHOL (BETTER IF WINE) USE OF A MAIN DISH (IT CONTAINS ALL NUTRIENTS) EXTRAVERGIN OLIVE OIL
CONCENTRATIONS OF THE MEDITERANEAN DIET Kcal/1g CARBOHYDRATES 3,75 55-60 % LIPIDS 9 <30 % OF TOTAL DAILY PROTEIN animals vegetables 4 12-15 % INTAKE VITAMIN AND MINERALS ALCOHOL 7
CORRECTED NUTRITION < 30% CARBOHYDRATES 12-15% 55-60% PROTEINS LIPIDS
DIFFERENT FOODS HAVE BEEN DIVIDED IN 5 DIFFERENT GROUPS TO MAKE EASIER THE KNOWLEDGE OF CORRECT NUTRITIONAL INFORMATIONS
THE 5 GROUPS GROUP 1 DESCRIPTION Meat, fish, eggs, dry legums NUTRIENTS High value proteins, Vitamins B complex, Oligoelements (Zinc,Cupper, Iron) GROUP 2 GROUP 3 GROUP 4 GROUP 5 Milk, yogurth, cheeses Bread, pasta, rice, mais, oat, barley, emmer, potato Vegetables origins oils (extravergin olive oil) and animals (butter, cream) Fruits, vegetables, fresh legums Calcium,High value proteins Vitamins (included B2 and A) Carbohydrates, Vitamins B medium value proteins Essential insature fats Liposolubil Viitamins (vit. A, D, E, K) Fiber, Vitamins (Provitamin A, vit C, etc..), Minerals, Antioxidants
If we daily eat food of the 5 different groups, with alternative choices, we would eat with a mediterranean diet in a correct and balanced manner. Legumes can be eaten twice / week or more.
Last but not least it has been shown that the Mediterannean Diet has a lower (50%) impact on our environment as compared to the other type of diets decreasing the greenhouse effect.
DIFFERENT PIRAMIDS (United States Department of Agricolture)
DIFFERENT PIRAMIDS
MAIN MISTAKES OF FAD DIETS LACK OF SCIENTIFIC EVIDENCES PROMISES OF RAPID WEIGHT LOSS MONOTONOUS FOOD CHOICES OR UNLIMITED FOOD OF SOME CHOICES (I.E FRUITS AND/OR VEGETABLES) MAGICAL FOOD OF FOOD COMBINATION (I.E.ONLY PROTEINS FOR LUNCH AND CARBOHYDRATES FOR DINNER OR VICEVERSA) RIGID AND WRONG REGIMEN (I.E.HYPERPROTEIC) Migliaccio P Manuale Nutrizione 2001, Roberts D, MJA 2001
LACK OF DIFFERENT NUTRIENTS SUCH AS PROTEINS, MINERALS, ETC ANEMIA, OSTEOPENIA (AND OSTEOPOROSIS) REGAIN OF THE LOST WEIGHT AFTER DISCONTINUATION OF THE DIET (REBOUND EFFECT) KETOSIS CONSEQUENCES OF FAD DIETS LOST OF LEAN BODY MASS UTILIZED FOR ENERGY LIVER AND KIDNEY OVERWORK IN HYPERPROTEIC DIETS
LOW CARBOHYDRATE DIETS (1) Low carbohydrate diets have a long history. In fact the Greek Olympians are said to have eaten high meat, low vegetable diets to improve athletic performance. Furthermore low carbohydrate diets appear to work, as they produce rapid weight loss in the first week. Since the body's demand for glucose is constant, body glycogen stores are mobilised and used in the early phases of a low carbohydrate diet, and for each gram of glycogen used 2-4 grams of intracellular H20 are lost (intracellular H20 maintains isotonicity). Roberts D, MJA 2001, Denke Am J Card 2001, Stein Am Diet Assoc 2000
LOW CARBOHYDRATE DIETS (2) Thus, there is greater water and hence weight loss in the early days of this type of diet. Water equilibrium is re-established in subsequent weeks, so that, in the longer term, weight loss simply reflects the energy deficit. Energy-nitrogen balance studies have demonstrated that the greater weight loss on a low carbohydrate, high fat diet is accounted for by losses in body waters. Roberts D, MJA 2001; Denke AmJ Card 2001; Stein Am Diet Assoc 2000
LOW CARBOHYDRATE, HIGH PROTEIN DIETS There is evidence that high-protein diets are more satiating. Individuals feel fuller and then eat less after a meal with a high protein content (31%-54% energy). A low fat, higher-protein diet (25% of energy) also produces a reduced energy intake and greater weight and fat loss over six months compared with a low fat diet with 12% energy from protein. Stubbs RJ Int J Ob Relat Met Disord 1995, Stubbs Am J Clin Nutr 1995, Roberts D, MJA 2001
LOW CARBOHYDRATE, HIGH PROTEIN DIETS (2) Another problem of high protein diets is the extra solute load placed on the kidneys leading to greater production of nitrogen waste products, particularly in situations of high water loss from perspiration or inadequate fluid intake contributing to dehydration. Stubbs RJ Int J Ob Relat Met Disord 1995, Stubbs Am J Clin Nutr 1995, Roberts D, MJA 2001
CONSEQUENCES OF LOW CARB DIETS Ketosis (formation of ketones such as acetone, acetoacetato, β-hydroxybutyrate (BHB), which might lead to intoxication. Some data suggest that the mild euphoria often noted with fasting or low-carbohydrate diets may be due to shared actions of BHB and GHB (γ-hydroxybutyrate) on the GABA B receptor in the brain. Liver and kidney overwork with alteration of several indexes (i.e hyperuricaemia) Brown A, Med Hypotheses. 2007
KETONES Acetone, Acetoacetate, -hydroxybutyrate (BHB). Acetoacetate: CH3 C=O CH2 C=O O β-hydroxybutyrate: CH 3 O=CH 2 CH 2 CH 3 Acetone: CH 3 C = O CH 3
MAIN HYPERPROTEIN DIETS ATKINS DIET Low carb, high proteins Unbalanced, high fats and cholesterol Important side effects (chetosis) SCARSDALE DIET High proteins Unbalance, it can induce ketosis and lack of nutrients ZONE DIET High proteins, low carbohydrates to avoid hyperinsulinism Unbalanced, high variability among individuals; goal: give psycophyisic equilibrium.
THE ROLE OF PASTA The use of pasta in either normocaloric or hypocaloric diets plays a pivotal role since it gives the correct amount of complex carbohydrates, high value proteins, fibers, vitamins and minerals. Thus, pasta can be considered an important food in both normocaloric and hypocaloric diets.
CONCLUSIONS In conclusion, data from clinical studies indicate that a low carbohydrates diet is not healthy, but often can be extremely unhealthy leading to several side effects in different organs.